Healthcare Provider Details

I. General information

NPI: 1972370328
Provider Name (Legal Business Name): DEVYN ESQUIBEL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 E SUNSET RD STE 100
HENDERSON NV
89014-2238
US

IV. Provider business mailing address

9348 HOSNER ST
LAS VEGAS NV
89178-6292
US

V. Phone/Fax

Practice location:
  • Phone: 702-465-8187
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7939
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: